Wiki what modifier to use on 96372 for Cahaba

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reneemiller

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Hello:

I appreciate any help you can offer on my question regarding 96372 administration of an injection. We are being told by Cahaba Medicare that 96372 requires a modifier for payment when billed with a J1030 or J1040. And, oddly that the modifier might change depending on the diagnosis used?? They are unable to provide us with what modifiers these might be, however.

Anyone familiar with this problem? Thank you!!!

Renee
 
Hi Renee,

The only modifier that I am aware of to use on 96372 is 76, but that is only if you are administering two seperate injections or if you also do a venipuncture 36415... Our office began getting denials for using 96372,59 when we had two 96372 or a 96372 and 36415 on same claim...when I called Cahaba, they told me that 76 was the correct modifier in our case.......I don't know anything about the dx having to do with what modifier you would use......

LG
 
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